When To Use Cannabis as a Substitute for Pharmaceuticals

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Medical marijuana advocates have celebrated cannabis as a non-toxic, non-addictive alternative to a wide range of prescription drugs. But while scores of patients have had success using cannabis as a substitute for pharmaceuticals, it's not for everybody.

For one, not every patient responds to cannabis in the same way. Though many have reported using cannabis to alleviate anxiety, for example, others experience heightened anxiety and paranoia when they smoke weed.

"If I feel situationally anxious, smoking weed can help me relax," a source who suffers from an anxiety disorder and requested anonymity told ATTN:. "However, if I have a panic attack—specific physical symptoms such as cold toes [and] hands, heart racing, trembling, sense of suffocation—smoking weed does not help."

"Sometimes a benzodiazapine [anti-anxiety medication] helps, sometimes meditation helps. Weed tends to just make me more convinced I'm having a heart attack or actually dying," she said.

Here's another example: patients might be compelled to use cannabis to treat mental health conditions such as depression instead of pharmaceuticals, but if a doctor has prescribed you anti-depressants, abruptly ceasing use of these prescription drugs can carry serious withdrawal symptoms. Because many prescription drugs contain ingredients that can be physically addictive, consulting your doctor for a recommendation on how to wean off of your prescribed medication is a must.

People are increasingly ditching addictive painkillers and finding relief with cannabis, too. Liberal marijuana laws are associated with fewer opioid-related overdoses, giving legalization advocates hope that marijuana can play a role in mitigating the harms of the opioid epidemic.

That said, painkillers have been shown to be effective as a short-term treatment option for acute pain—like after you undergo a surgery or during end-of-life care.

Dr. David Bearman, who specializes in medical marijuana, said "there are different answers for different diagnoses," making it difficult to say when a patient should use cannabis in lieu of pharmaceuticals. But he emphasized that "it need not be either/or."

"You can often take cannabis in conjunction with prescription medications, as with opiates," Bearman said. "In that case cannabis often allows the patient to decrease their dose of opiate pain medication."

Mark Zartler, who uses vaporized cannabis to treat symptoms of his daughter's severe autism, told ATTN: that cannabis has enabled her to reduce her dosage of risperidone, an antipsychotic medication, by 80 percent. But he said they probably won't ever be able "to get her all the way off prescriptions."

"We've tried," Zartler said. "We have been able to substitute with Abilify and risperdone [...] as needed, but she still needs some. Cannabis mixes well with these products for severe autism."

Patient surveys have revealed that cannabis is most commonly used as a substitute for opioid painkillers (36 percent), compared to anti-anxiety medications (14 percent) or antidepressants (13 percent). The appeal of replacing pharmaceuticals with cannabis is clear: pills can have numerous side effects, lead to addiction, and have contributed to record-high overdoses in the United States.

Bearman said there is one diagnosis for which he wouldn't recommend using cannabis as a substitute. "When treating cancer, do not use cannabis instead of conventional treatment. Use it in addition to chemo or radiation," he said.

Before you make any kind of switch, though, it's important to consult your primary care doctor as well as the doctor who writes your medical marijuana recommendation to make sure that you safely wean off pharmaceuticals and effectively integrate cannabis into your treatment regimen.